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RPSGT Domain 4 Proctored Final Assessment Review 2026 (With Solns

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RPSGT Domain 4 Proctored Final Assessment Review 2026 (With SolnsRPSGT Domain 4 Proctored Final Assessment Review 2026 (With SolnsRPSGT Domain 4 Proctored Final Assessment Review 2026 (With Solns

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December 8, 2025
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RPSGT

Domain 4: Treatment & Intervention


Final Assessment Review


(With Solutions)



2026




1

,Multiple Choice
Which PAP therapy mode adjusts pressure automatically to maintain
airway patency throughout the night?
A) CPAP
B) Bi-level PAP
C) APAP
D) ASV
Answer: C) APAP
Rationale: APAP automatically varies the pressure to prevent airway
collapse based on detected events.

Adaptive Servo-Ventilation (ASV) is primarily indicated for which
condition?
A) Obstructive Sleep Apnea (OSA)
B) Central Sleep Apnea (CSA) and Cheyne-Stokes Respiration
C) Mild snoring without apnea
D) COPD with hypercapnia only
Answer: B) Central Sleep Apnea and Cheyne-Stokes Respiration
Rationale: ASV adjusts pressure support breath-by-breath to stabilize
ventilation in central sleep apnea.

When initiating Bi-level PAP, which setting corresponds to the
inspiratory positive airway pressure?
A) IPAP
B) EPAP
C) CPAP
D) PS
Answer: A) IPAP
Rationale: IPAP is the pressure during inspiration to assist ventilation.

Which oxygen delivery device provides the most precise FiO2 during
oxygen therapy?
A) Nasal cannula
B) Simple face mask
2

, C) Venturi mask
D) Non-rebreather mask
Answer: C) Venturi mask
Rationale: Venturi masks use color-coded adapters to deliver fixed
FiO2.

True/False
True or False: ASV can be used safely in heart failure patients with
central sleep apnea.
Answer: True
Rationale: ASV is specifically designed for these patients, but
contraindicated in low ejection fraction heart failure patients (always
verify cardiac status).

True or False: Starting CPAP therapy at too high a pressure can
increase patient discomfort and decrease compliance.
Answer: True
Rationale: Gradual titration improves tolerance.

Short Answer
Define NIPPV and give two clinical scenarios where it may be
preferred over standard PAP therapy.
Answer: NIPPV stands for Non-Invasive Positive Pressure Ventilation,
delivering ventilatory support without an invasive airway. It’s
preferred in COPD exacerbations and neuromuscular weakness with
hypoventilation.
Rationale: NIPPV supports ventilation by augmenting breaths, useful
when hypoventilation is present.

Describe one major contraindication for oxygen therapy in patients
with chronic obstructive pulmonary disease (COPD).
Answer: High flow oxygen can cause CO2 retention leading to
respiratory acidosis in COPD patients prone to hypoxic drive
dependence.
Rationale: Oxygen toxicity and worsening hypercapnia can occur with
3

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